Department of Cardiology, Oslo University Hospital, Faculty of Medicine, University of Oslo, Oslo, Norway.
Cardiovasc Diabetol. 2010 Sep 15;9:52. doi: 10.1186/1475-2840-9-52.
The cardiac troponins are biomarkers used for diagnosis of myocardial injury. They are also powerful prognostic markers in many diseases and settings. Recently introduced high-sensitivity assays indicate that chronic cardiac troponin elevations are common in response to cardiovascular (CV) morbidity. Type 2 diabetes mellitus (T2DM) confers a high risk of CV disease, but little is known about chronic cardiac troponin elevations in diabetic subjects. Accordingly, we aimed to understand the prevalence, determinants, and prognostic implications of cardiac troponin T (cTnT) elevations measured with a high-sensitivity assay in patients with T2DM.
cTnT was measured in stored, frozen serum samples from 124 subjects enrolled in the Asker and Bærum Cardiovascular Diabetes trial at baseline and at 2-year follow-up, if available (96 samples available). Results were analyzed in relation to baseline variables, hospitalizations, and group assignment (multifactorial intensive versus conventional diabetes care for lowering CV risk).
One-hundred thirteen (90%) had detectable cTnT at baseline and of those, 22 (18% of the total population) subjects had values above the 99th percentile for healthy controls (13.5 ng/L). Levels at baseline were associated with conventional CV risk factors (age, renal function, gender). There was a strong correlation between cTnT levels at the two time-points (r=0.92, p>0.001). Risk for hospitalizations during follow-up increased step-wise by quartiles of hscTnT measured at baseline (p=0.058).
Elevations of cTnT above the 99th percentile measured by a highly sensitive assay were encountered frequently in a population of T2DM patients. cTnT levels appeared to be stable over time and associated with conventional CV risk factors. Although a clear trend was present, no statistically robust associations with adverse outcomes could be found.
心肌肌钙蛋白是用于诊断心肌损伤的生物标志物。在许多疾病和情况下，它们也是强大的预后标志物。最近推出的高敏检测方法表明，心血管（CV）发病率会导致慢性心肌肌钙蛋白升高。2 型糖尿病（T2DM）使 CV 疾病的风险很高，但关于糖尿病患者的慢性心肌肌钙蛋白升高知之甚少。因此，我们旨在了解在接受 2 型糖尿病治疗的患者中，使用高敏检测方法测量的心肌肌钙蛋白 T（cTnT）升高的患病率、决定因素和预后意义。
在 Asker 和 Bærum 心血管糖尿病试验中，在基线和 2 年随访时（如果有）测量了 124 名受试者的储存冷冻血清样本中的 cTnT（可分析 96 个样本）。结果与基线变量、住院和组分配（多因素强化与常规糖尿病护理以降低 CV 风险）相关进行了分析。
113 人（90%）在基线时可检测到 cTnT，其中 22 人（总人群的 18%）的数值高于健康对照组第 99 百分位（13.5ng/L）。基线水平与常规 CV 危险因素（年龄、肾功能、性别）相关。两次测量时 cTnT 水平之间存在很强的相关性（r=0.92，p>0.001）。在随访期间，根据基线 hscTnT 测量的四分位数，住院风险呈阶梯式增加（p=0.058）。
在 T2DM 患者人群中，通过高度敏感的检测方法测量的 cTnT 升高超过第 99 百分位的情况经常发生。cTnT 水平似乎随着时间的推移而稳定，并且与常规 CV 危险因素相关。尽管存在明显的趋势，但没有发现与不良结局具有统计学意义的关联。
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